Prescribing for Presbyopia

A Look at the Next Generation of Presbyopes

prescribing for presbyopia

A Look at the Next Generation of Presbyopes


Having been in one practice setting for more than 30 years, there is something I've discovered — your practice grows old with you. During my first 10 years we refit PMMA wearers into GPs; the next decade was spent fitting first-time wearers with soft contact lenses; and over the last 10 we've been helping baby boomers either start or continue in bifocal and multifocal contact lenses.

But now that boomers are reaching maturity, what is the next generational group — the newly emerging presbyopes — going to be like in your practice?

Characteristics of Generation X

Generation X was born from the middle 1960s to the early 1970s and is approximately half the size of the baby boomer group that preceded it. They are the first generation to reach maturity sitting in front of computer screens while talking on mobile phones.

Unlike boomers, these patients embrace technology, constantly looking online for everything from parenting advice to consumer products. They use the Internet, along with mobile phones, as a convenient way to shop, bank, and network with peers.

Visually, this can be challenging. Having come of age in an era of technological advancements, Xers don't want to give up or struggle to see when using their laptop or Blackberry/Smartphone; they expect to text message all day long. Plus, they consider a GPS device as an essential travel accessory.


Most patients in this age group think of soft lenses for non-spectacle visual correction because so few have been exposed to GPs. They also started wearing contact lenses while very young and simply expect them to work whenever they want to wear them. Television and online advertising efforts by lens manufacturers have also increased awareness that contact lenses for presbyopia are available and that they work.

Most importantly, these patients are not ready to give in to Mother Nature and they prefer to continue wearing contact lenses.

How to Reach These Patients?

Gen Xers grew up on MTV, cable television, and e-mail. Thus, they are likely to be immune to traditional advertising media such as newspapers and direct mail, instead preferring to be communicated with electronically.

So, continue to acquire your patients' e-mail addresses, develop a practice e-newsletter, update your Web site, and add online ordering capability.

Managing Gen Xers

We used to wait as long as possible before switching emerging presbyopes to multifocal contact lenses — but not so with Generation X. For them we employ three strategies: discuss the symptoms of presbyopia very early, dismiss monovision as an option, and fit in a presbyopic lens design as soon as symptoms arise. In fact, we now present multifocal soft lenses to patients three-to-five years sooner than we did before. Manufacturers have many designs with low add powers that work well for emerging presbyopes.

Generation X is different, and we should cater to their needs as they enter into presbyopia. CLS

Craig Norman is director of the Contact Lens Section at the South Bend Clinic in South Bend, Indiana. He is a fellow of the Contact Lens Society of America and is an advisor to the GP Lens Institute. He is also a consultant to B&L.